ATnpuwpctwda3mpimbrpa

APN

AK

IObsdchoot

PcpthaureanCCAD

Af

Cynthia L1Human

ABSTRACT This paper is normalcy emprostheses. Draupper-limb loswe find peopprosthesis throcomplex relatioechnology ofte

we found that pdevelopment ofa prosthesis fai3D-printed promaker commupraised the dempacts on p

building. This role of designpromise of makand a broader d

Author KeywoProstheses; AbiNormalcy; Des

ACM ClassificK.4.0 Compute

NTRODUCTIOOver the last dbody of work systems and indisabilities go concentrates ohuman ability aof prosthetics other work haechnologies c

Permission to make dlassroom use is grant

profit or commercial ahe first page. Copyr

author(s) must be honepublish, to post on s

and/or a fee. Request pCHI'16, May 07 - 12, 2Copyright is held by thACM 978-1-4503-336DOI: http://dx.doi.org/

An Intimfor Exp. Bennett1 Centered DUniversity o

Seattl

about the aspmbodied in pawing on intervss and diversele not only

oughout their lonships with then focuses on prostheses playf identity and siled functionalostheses createunity (e-NABsign and initi

popular culturwork surface

n interventionsker communitidefinition of “a

ords ility; Assistive

sign Interventio

ation Keyworders in Society: g

ON decade, the HCoriented towanfrastructures about their d

n building syand complemeand occupati

as recognized an become em

digital or hard copiesed without fee providadvantage and that corights for componentnored. Abstracting witservers or to redistribupermissions from Perm2016, San Jose, CA, Uhe owner/author(s). Pu62-7/16/05…$15.00 /10.1145/2858036.28

mate Laperimen

KetDesign and Enof Washingtole, USA

{bennec

pects of abilitypeople’s relaviews with 14 experiences wchoose to uslives but also hem. The desigenhancing fun

yed important rsense of normally, such as waed by an on-lLE), we fouative because

re, identity, aes crucial quess in identity ies for acceleraassistive” techn

Technology; Ions.

ds general.

CI community ard “assistive”

devised to hedaily lives. Thystems to enhents investigational therapy. how the bod

mbedded in p

s of all or part of thided that copies are notopies bear this notice ts of this work ownth credit is permittedute to lists, requires pmissions@acm.org. USA ublication rights licen

58564

aboratonting wting Cen1 ngineeringon

c3, cenkt, km

y, selfhood, anationships wiindividuals wiwith prosthesese and not u

form close angn of “assistivnction; howeveroles in peoplealcy. Even whas the case wiline open-sourund people st

of the positivand communistions about thproduction, th

ating innovationology.

Identity;

has built a ritechnology: th

elp people wihis work largeance or replaions in the fiel

More recentldy and assistivpeoples’ lives

is work for personal t made or distributed and the full citation

ned by others than td. To copy otherwise, prior specific permissi

nsed to ACM.

ory? Proith Iden

Kath

msteele, dkro

nd ith ith es,

use nd

ve” er, e’s en ith rce till ve ity he he

on,

ch he ith ely ace ds ly, ve in

ways taesthetwith diof makdefinitidoing makingsomethprojectmanufa

Our paassistivthe synaugmecommucommuIvan ORicharthey cdetermyear, athe inavailab

e-NABMechaartists, establiinfluenchief Crevolutproduc

orforontheor

ion

Fi

osthesntity anerine M. St

2MechUnive

osner}@uw.

that reach beyotic identificatiiscussions of cker and hackeions of “user”so, HCI has cg and technhing should dots, from online

facturing [10, 1

aper builds on tve technology nthetic body p

ent the body —unities, such aunity emergedOwen, a proprd Van As, a ccreated a 3D

mined to releasa community conitial designs, ble for public d

BLE organizeranical Hand M enthusiasts anshment ripe fo

nce of 3D-prinChris Andersotion,” wouldction. Specia

igure 1: Hand pcentury. C

es as and Normteele2 Dhanical Engiersity of Was

Seattle, US.edu

ond function tions. This wocustomization, er culture by

” and “use” thecontinued to bnology: askino or look like e distribution 5, 32].

this blending oto consider th

parts such as l— and associatas e-NABLE.

d from an onlin maker from carpenter from

D-printed prostse its designs oalesced, build

making hundownload [11].

rs framed theMaker Moveme

nd engineers ior disruption.

nting, and whaton [4] has famd thoroughly alized 3D-pri

prostheses fromCopyright: Pete

a Tool malcy Daniela K. R

ineering shington A

to consider affork has recent

emerging in Hexamining th

ey present [7, broaden its defng who deci

across a broaplatforms to s

of maker sensibhe work of prolegs, arms or ted grassroots

In 2013, the ne collaboratio

the United Sm South Africa

thetic hand afreely online

ding upon and ndreds of han.

ir initiative aent,” a loose nintervening in To many, it st former Wiredmously called

transform inters would

m 15th century ter Finer LTD.

Rosner1

fective and tly met up HCI studies e different 13, 17]. In finitions of ides what

ad range of small-scale

bilities and ostheses — hearts that fabrication e-NABLE

on between States, and a. Together and Owen . Within a improving

nd designs

s the “3D network of

a medical seemed the d editor-in-

a “maker prosthetic

d develop

o 21st

biomimetic tissues [18] and low-cost bots [25] would produce custom prostheses. Within the popular imagination of news media, this turn to open-source hardware engineering promised to upend a perpetual and tumultuous demand for medical resources and its sometimes-fatal consequences. But what has small-scale manufacturing and innovation actually brought to people’s daily lives, and how might HCI help address these challenges? What, for that matter, might a study of everyday prostheses bring to HCI’s examination of assistive technology?

This paper examines these questions by drawing on interviews with 14 individuals with upper-limb loss and our ongoing experiences developing and observing prostheses. Our research team was comprised of three design researchers and a mechanical engineer contributing to the design of assistive technology. Through our engagements and interviews we saw that while at first prostheses seem to invite an examination of functionality (extending what the body can do), upon closer inspection we find people also project ability-focused and normative identifications onto their prostheses (shaping what constitutes a body).

Three possibilities follow from this observation. First, we invite the consideration of “assistive technology” as not only tools for improving function, but also as important sites of identity production and experimentation. This possibility has important ramifications for HCI research as sites of technology development become increasingly entwined with the body, shifting who has responsibility for technical production, maintenance and development. Second, our work reminds HCI designers and scholars that ability and disability are not static categories. Instead, ability encompasses a complex array of social forces, including the economic constraints and institutional arrangements such as medical care.

Our final insight points to the important role communities like e-NABLE play in the development of ability identity, the sense of self produced through one’s capacity to perform a given act. Shortcomings such as mechanical breakdowns, poor performance, and inconvenient maintenance threaten the physical support 3D-printed prostheses may provide. Yet e-NABLE demonstrates other provisions. More than support instrumental achievements, people use e-NABLE as a site of identity formation that helps people build new community partnerships and perceptions of self. This suggests that HCI analyses extend beyond individual users to consider the broader organizational structures at play: the way communities like e-NABLE may fall short in meeting certain expectations of the people they serve while supporting others.

Together, our examination of prostheses and e-NABLE allow us to rethink the “assistive” in the design of assistive technologies. What features we attribute as assistive, may in fact perturb certain actions while facilitating others. Here we challenge HCI research to account for these often hidden consequences of assistive technology development.

At stake is an attempt to define how people construct the self and ideas of normal in their own intimate laboratories.

DEVELOPMENTS IN PROSTHESIS DESIGN To understand the role of prostheses today and the promise they hold for HCI inquiry, we first review the current state of prosthesis design, fabrication, and use.

Prosthesis in Historical Perspective: Form and Function As an artificial device that replaces a missing or impaired part of the body, evidence of prostheses in daily life extend to the Egyptians [23]. Archaeologists have discovered a variety of prostheses with Egyptian mummies, including toes and hands with detailed paintings of features. The evolution of intricate devices to replace the hand (Figure 1) include the famous iron hand of Götz von Berlichingen, an imperial knight and poet from the 15th century [42].

Since these early designs, people have developed numerous forms of prostheses to assist individuals with upper-limb loss. Prostheses can either be passive, worn for cosmetic reasons and having no moving parts, or active, enabling movement to enhance function. Active prostheses are typically body-powered, using a series of cables connected to other body parts, such as the shoulder, to create movement. More recently, companies have introduced myoelectric prostheses, [20] which use muscle activity to control movements of an electrically-powered device. To mimic the hand, various terminal devices are available for use at the end of the prosthesis. Prosthetists report that hooks are often considered functionally superior terminal devices because they allow people to see what they are manipulating and have high strength [5]. However, many people prefer terminal devices that look and feel like a human hand [6, 14]. The individuals interviewed in this study had diverse experiences with these many different types of upper-limb prostheses and, as we will see, had often tried one multiple designs.

Prosthesis Fabrication Prior to the late 1940s, prostheses were fabricated by generally trained ‘fitters’ [1]. Today, prosthetists receive graduate-level training and certification to fabricate, fit, and customize prostheses and sockets for individuals with limb loss [21]. During what can be a time-intensive process, they work with each user to determine the best prosthesis given their disability, personal goals, and medical coverage. In the US, upper-limb prostheses typically cost between $3,000 - $15,000, but sometimes upward of $60,000 depending on the complexity and design.

Considering prostheses use, researchers have conducted several studies including [16, 31, 34], few of which are on people’s perceptions of upper-limb prostheses beyond evaluating functional performance and acceptance. A literature review [19] described participants’ adjustment and learning when transitioning to life with an amputation, finding supportive relationships crucial as they can encourage positive coping. Prostheses also contributed to allowing participants to feel whole again. Overwhelmingly,

thwrth

eSthv(Hmomcliph[cccVp

AesuNmthcyssHbp

LIa

his prior workwith limb lossrehabilitation herapists.

e-NABLE Since 2013, thehese traditiona

volunteers with(Figure 2). ThoHand Project missions, we fon underservedmay be too excoverage, or imimited option

prostheses. Anhand can subm11] and a v

community mecosts for each covered by theVolunteers andprosthetic hand

As of Septemestimated 1,50source and shaunknown. FewNABLE thougmeasuring hanhe e-NABLE

community anyears seems prsignificant concsafety, reliabiliHere we explorboth traditionprosthetists and

LITERATURE RIn the sections and social scie

Figure 2: PiecNABLE han

k has documen through prospractitioners

e e-NABLE coal patterns of prh people wishough other org[39] and Ope

focus on e-NAd populations foxpensive, such mpractical, suns available ny individual wmit an intake fovolunteer “matember who ca

hand are lese volunteers, od users often wds to fit each pe

mber 2015, e00 hands [11],red on Thingiv

w articles havgh Zuniga [46ds in person o

E community. d proliferationromising at thcerns from theity, and regulred the experienal prosthesed 3D-printed pr

REVIEW that follow wence literature

ces of e-NABLEnd (right). Phot

nted the experithesis usage a

such as p

ommunity hasrosthetic fabriching to try 3Dganizations, suen Bionics [2

ABLE here. e-Nfor whom tradit

as for those uch as for chi

and quickly who would liorm on the e-Ntchmaker” wian 3D-print a ss than $50 anoutside donatiowork together terson’s needs.

e-NABLE ha, but since deverse [41], theve been publ6] compared tor based on ph

The rapid n of designs ihe surface, althe medical commation of these

ences of peoplees fabricatedrostheses from

e consider two that inform ou

E hand (left) andtos taken by res

iences of peopand has targetprosthetists an

contrasted wication to conneD-printed hanuch as the Op24], tout similNABLE focustional prostheswithout medicldren who hav

outgrow theike to receive NABLE websiill find a loc

hand. Materind are typicalons, or the useto customize th

s delivered esigns are ope entire impact lished about the accuracy hotos to suppogrowth of thin the past twhough there amunity about the hands [2, 22e who have us

d by certifim e-NABLE.

areas of the HCur analysis: fir

d assembled e-search team.

ple ed nd

ith ect nds en lar ses ses cal ve eir

a ite cal ial lly er. he

an en-

is e-of

ort he

wo are he 2]. ed ed

CI st,

studiesenact secondand its

AssistTo conthe HCinteracMihalyThese peopleactionsidentififamily

Other consid— emplike) naof selfhButler,reproduneed nthat thdeed” mainta

TakingproducrecommhumanproducBuildinsettingdesigniuniqueimpact

While assistivfrom thlimits Kathlewomanlarge lpoint tWoodwpregnaage-relpeoplemay reThese media living ability affectivSobchalower

s that examineideas of selfh

d, work that in recent attentio

tive Technolognsider the prodCI communityctionalism of Ey Csikszentmithinkers have

e associate wits, emphasizinfications those

[26, 27].

work breaks er the productphasizing the oature of values

fhood in this ar, who emphauction of iden

not be a ‘doer he ‘doer’ is va

[8]. Rather ained through i

g these concection in HCI, mend treating

n and machineced and enacteng upon these

g for such tecing for more t

e social settint identity const

largely absentve technology he field of cine

of age and een Woodwardn (artist Louiselatex costume that our percepward likens thant older womlated objects.

e’s abilities (hemain fixed, rconcerns for theorist Viviawith a so-caidentity (wha

ve identity (whack reflects o

limb to fra

how people afhood — with nvestigates the on in the maker

gy Objects anduction of idey has readily Erving Goffmaihalyi and Eu

e led HCI reseth technical arng the symartifacts enac

from a fixedtion of meaniongoing proces and identificarea comes fromasizes the co

ntity through dabehind the de

ariably construthan endless

its worldly eng

erns to the pSuchman [38

g a categorice as neither ined within a soce thinkers, wchnology prodtypes of bodie

ngs with normtruction and pro

t in HCI literatand identity

ema and mediaability perce

d [45] analyze Bourgeois) w

designed to ptions of abilithis image to anman accompani

. While techhere, older worefusing to rew

visibility andan Sobchack’s

alled ‘phantomat she calls “obhat she calls h

on her experieame her cond

associate meantechnical artifproduction of r movement.

nd Identity ntity around tturned to the

an and the psyugene Rochbeearchers to thertifacts throughmbolism and ct for the indi

d notion of ming through pessual (rather thations. A princm feminist theoontinual produaily encounter

eed,’” Butler wucted in and thly fluid, the

gagements.

practices of t8] and Van Hcal distinction

nevitable nor ncial and mater

we consider thduction as it es, and designimative expectaoduction.

ture, a rich disproduction ha

a studies. Conseption, culturazes a 1975 imwalking the str

signal age. Mty raise culturan illustration died by a canehnologies maomen), culturawrite its cultud the body res [36] autobio

m limb’. Compbjective body”her “phenomenence of losingdition as an

ning — and facts; and, prostheses

echnology, e symbolic chology of erg-Halton. e meanings h everyday

affective vidual and

meaning to erformance han object-ciple notion orist Judith uction and s. “[T]here

writes, “but hrough the

self gets

technology House [44] n between natural, but rial setting. he material

relates to ing for the ations that

scussion of as emerged sidering the al theorist mage of a eets with a

Making the al tensions, depicting a

and other ay change al imagery

ural scripts. esurface in ography of paring her ”) with her nal body”), g her own

“intimate

laboratory”: a site for examining, testing and reflecting on her body.

Our study builds on Woodward’s concern for the ability-marked body and Sobchack’s concept of the “intimate laboratory” to consider how assistive technology interfaces with the body as an experimental platform for identity production, specifically with a focus on individuals with upper-limb loss. While Sobchack’s laboratory remained tied to her “phantom” limb and body, the laboratory of our interviewees invites a range of design interventions. As we will see, this requires extending HCI’s treatment of the way things like prostheses develop capacities for identification and normative action.

Assistive Technology and Manufacturing A growing body of recent work considers the promise of collaborative tinkering around assistive technology through services like Thingiverse, a platform for documenting and sharing digital 3D-models [7]. In fact, researchers have recognized the potential for making to be an empowerment tool for people to create their own assistive technology [13]. Yet Buehler et al [7] found that makers and users of assistive technologies are largely disconnected. They recommend providing communication channels for easier collaboration among makers and users, more standardized search terms so assistive technology designs are easier to find, and more accessible tools as methods for closing this gap.

Regarding making and prostheses, Ratto’s [29] exploration of 3D-printing, prostheses, and their intersection helps distinguish computational processes meant for mass production from the art of making unique designs. They noted that all residual limbs differ and demand personalization. Other related maker communities include Schmidt et al’s [33] easy-to-use tool for scanning residual limbs and Record et al’s [30] open-source kit to educate communities about prosthetics and human augmentation. This work connects to Woodward’s concern for the cultural scripts that influence perceptions of ability and how individuals may use assistive technology to draft those scripts.

How maker communities and DIY will influence and shape cultural scripts related to assistive technology remains an open question. Advocates claim makers “are reshaping how people consume and interpret the handmade”. Informal learning websites such as Skillshare [35], help coordinate meetups and exchange techniques. Instructional how-to websites enable users to create and share online instructions for making, fixing and customizing everyday goods. Pattern-sharing websites such as Ponoko [28] complement co-working sites to offer a diverse means of sharing corporeal knowledge in person and online. In concert, researchers including a 2014 panel at CHI [3],, Toombs et al’s work [43], and afore mentioned [10, 15, 32] question the espoused democracy of the maker movement where women and minorities are underrepresented. Toombs work

specifically deconstructs maker community practices to demonstrate the necessity of care and other collectivist values for community maintenance. Though we do not investigate democracy and representation here, the discussion is highly relevant as people with disabilities begin to be recognized as makers. Through examining how people make things and share them with others, scholars question how digital tools enhance people’s engagement and connection with the world. This paper examines the promise of maker communities and digital fabrication for assistive technology, specifically with a focus on prostheses.

By speaking with people about their lived experience with upper-limb loss, we ask two questions. First, how do prostheses help shape the body’s role in ability and normative identifications? To address this question we consider the ways participants presented themselves and how they incorporated prostheses and limb loss into everyday life. Second, what emerges from maker communities who are aimed at “disruption” of century-old practices supporting people with limb loss? We learn how the e-NABLE project works to support and sometimes disrupt its own beneficiaries, the people building and maintaining 3D-printed prosthetic hands.

Together these questions highlight how limb loss and prosthetic intervention interface to form an intimate laboratory through which people experiment with identity production, develop new concepts of normative action, and use making as a platform for communities coalescing to challenge notions of who should make and what should be made.

METHODS Our analysis draws on fourteen interviews with people with upper-limb loss and Steele’s ongoing work in prosthesis design. Nine adults were recruited through local prosthetists and five through an email to adults who received 3D-printed hands from the e-NABLE community. Given our questions about identity and normative discourse, we interviewed adults who have arguably had more experiences forming and presenting their identities, rather than children who have thus far constituted the primary group to which e-NABLE has distributed devices.

Our interviewees varied in their physical ability and use of prosthetic devices. In hopes of contextualizing our findings with characteristics of our participants related to limb loss, we recognize language commonly used in medical fields, and borrowed here, as ablest. Ten had congenital limb loss (born without part of their limb), and four had amputations later in life, most missing either parts of their hand or forearm (transhumeral / transradial). All had prior experience with prostheses to different degrees. While six participants used their prosthesis on a daily basis (myoelectric and body-powered), three others had extensive past experience using a body-powered prosthesis, but choose to not use their device anymore. The five people

who received e-NABLE hands chose to not use them, or any other prosthesis, regularly.

We sought stories during interviews by encouraging participants, anonymized with pseudonyms, to direct the conversation. We probed further by greeting responses with relevant follow-up questions. Prompts on the interview guide included ‘What does the term prosthesis mean to you?’ and ‘Tell us about a time someone noticed your prosthesis.’ Interviews were recorded and transcribed. We generated stories from interview transcripts based on successive rounds of open and thematic coding, alongside the production of analytic memos that we discussed among the project team as forms of intermediate writing (following Grounded Theory principles [9, 12, 37]). We used “vignettes” (short narrative reflections) to highlight the situated character of participants’ everyday engagements with prostheses, an approach applied widely in sociology and anthropology. The vignettes contextualize accompanying quotes that pinpoint how prostheses have influenced identity production and explorations of normalcy. In the section that follows we sketch some of these diverse and surprising encounters with prostheses in people’s daily lives.

FINDINGS Whether or not they “used” one, the adults we spoke with considered prostheses part of an ongoing process of development: of who they saw themselves as individually, of who they saw themselves becoming collectively, and of how they desired to look, act and relate to others across time. A first facet of this concerns their preferences for certain prosthetic interactions, conveyed through descriptions of their body and the formal qualities of their prostheses. Our interviewees further conceptualized normative expectations, sometimes complying with them to present a two-armed body while other times using limb loss and prostheses to violate those expectations. Cultivating attention from others, they described using interventions on their bodies as a basis for aesthetic exploration and embellishment such as costume. This interest in experimentation met its match in e-NABLE, a community that presented new technical opportunities. The people we spoke with dealt with functional failures such as faulty hardware and inaccessible assembly of their e-NABLE devices while recognizing the importance of the broader social network it supported, a community enriching opportunities to connect with other people with limb loss.

Perceptions of Self and Ability Across our interviews, we learned of experiences with prostheses that uniquely contributed to people’s formation and presentation of self. We found that a strong influent of identity production was in how they viewed themselves most able to function, sometimes with a prosthesis, and sometimes without. Although function guided whether they used a prosthesis, function was a fluid construct interpreted based on people’s ongoing sense of ability identity. We first highlight Christina, a prosthesis user whose prosthesis use became so deeply engrained that she felt switching devices threatened her sense of self. We continue by sharing stories from two participants who describe feeling most able when not using a prosthesis. With or without a prosthesis, presenting an able self became a focal point of identity construction.

From “The Girl with a Hook” to Having a Dazzling Arm We turn to Christina’s story which demonstrates how prosthesis use influenced identity through life transitions:

Christina used prostheses all her life. At 17, she learned that insurance would change coverage when she became an adult. Her doctors encouraged her to try a more-expensive myoelectric hand, and the decision to transition did not come easily. She had built a strong identity as, in her words, “the girl with the hook.” She admitted that aesthetics was more important to her then, and the thought of fitting in as a girl with two hands at college sounded like a “real treat.” However, she struggled: “Learning to use the device was foreign to me.” Beyond the difficulty of learning how to function with the prosthesis, fitting in came with emotional costs: “My reflection in the mirror was no longer what I was used to. …I felt like a sell out, I mean I felt ashamed of myself because I felt I valued cosmetics when I had done so much work on who I was.” Christina built an identity as a girl with a hook, but chose to try a new prosthesis to fit in at college as someone with two hands in an attempt to present a self that she perceived would be more normal to others.

Ultimately, she chose utility, switching back to using a hook instead of keeping the fancier hand, but she continued to use her prosthesis as a form of self-expression. “I decided that I was going to make a little bracelet of crystals for my forearm at the end, kind of like a tennis bracelet…So I had extra crystals (laughs) so I just kept going, and then I got more and more and more and it became a lot of fun, and it (Figure 3) gets a lot of attention and people love it. Like in the sun it is so sparkly, like carrying my own disco ball…It is my style, and it is a representation of me.”

Cid“uawppr“losp

Nbppaae

CpcaAinwimpsinstucbop

Cpp

Christina expldentity. As a c

“the girl with underwent the a hand prosthwhatever cosmpresent the moprosthesis. Norepresent herse“When it had jook at it at th

start a converspeople love it.”

Not only does but she uses it tproduction hasprostheses. Waccelerates it. assumed to expectations an

Christina’s stopresentation acircumstance. Sattracted and Although she dn college, as s

when choosinmportant to h

paid her by spectacle. Prosntegrated, that

self could not urned into a p

clearly in her became an intimone componenplatform for ide

Christina’s stoparticipants whpresentation. W

Figure 3: ChriPhoto

licitly used hechild, it definedthe hook.” In difficult identiesis. However

metic advantagost able self bow, she has elf and to guijust been the b

he corner of thsation… [now]”

Christina’s spato attract posits changed the

What at firstDecorating a

increase funcnd provides a p

ory illustratesas mediated She was proud

presented codecided to try ashe matured, utng a prostheser, and she prmaking her

stheses becameher notion of abe separated.

platform for selove for makmate laborator

nt, providing entity producti

ory parallels ho found prosthWhether enabli

istina’s sparkly os used with par

er prosthesis d her as she co

hopes of betteity and functior, she ultimatee a hand provby switching decorated he

ide the reactioblack forearm,

heir eye, but th] it gets a lot

arkly prosthestive attention. H

way people at stifled conan assistive dction, deviateplatform for sha

s the malleaby limb lo

d of the attentioonfidence in a more realistictility became t

sis. Yet aesthreferred to sha

prosthesis ae a central parability and herWhat began a

elf-expression, king jewelry. Cry of which hephysical funcon.

the experieheses an imporing activities f

arm and Brianrticipant permi

to present honsidered herseer fitting in, shnal transition ely decided thvided, she couback to a hoo

er prosthesis ons from other, people used hey would nevof attention an

is represent heHer very identiaround her vienversation nodevice, which es from othearing.

ability of seloss, time, anon her prosthesher daily lif

c prosthetic hanthe driving forhetics remainape the attentioan eye-catchinrt of her life, r presentations as a mere devi

illustrated moChristina’s boder prosthesis wctionality and

ences of othrtant part of selfrom enjoying

n tying his shoe.ission.

her elf he to

hat uld ok to rs. to

ver nd

er, ity ew ow

is ers

lf-nd sis fe. nd rce ed on ng so of ce

ost dy

was a

her lf-

g a

glass osupporindepewould that taprosthemaking— peoability,themse

“The ganythiWhile percepidentitychose nwe turnpart ocommo

“Everyam noanythinLike I anythin

A congafter hconsidway.” abilitytasks sduring himseldemonmay beideas w

SimilarHer limboth ashe couShe huenticedwas likdown mKelseyprosthecomplea back foam tu

For bomake sthe devwithoutheir boby crewhich

of wine in therted their deendent self. “If

be possible,”asks could be esis — whethg a mess, or haople often sou, and this welves with pros

guy who is mising.”

prostheses pptions of self foy and ability wnot to use a pr

rn to Brian, whof who I am.only associated

y time I call mot actually disng. But I just am the guy w

ng.”

genital amputehe had “alreered them “uHe felt his proand develop

such as demonthe interview

lf a “guy mnstrates how tecome with idwere even state

r to Brian, Kemb difference arms, but she auld complete taumorously refd her to use a pke I could eat 5my hand to picy maintains tesis, she usesete everyday tascratcher to op

ubes for easier

oth Brian and Ksense at a youvices on accou

ut them. Ratheodies, an intim

eatively interfarepurposemen

e evening to desired presentaf I didn’t have ” one woman

accomplished her pouring fammering nailsught to prove owas reflected stheses.

ssing a hand,

layed an impor some individ

were tightly courosthesis. To uho described l.” Brian heard with him, but

myself disabledsabled ‘cause don’t really kn

who is missing

ee, Brian tried peady learned nnecessary,” nosthesis hindered several wnstrating to u

w (Figure 3). missing a hantightly woven dentity producted together.

lsey encounteris more prono

also reported asks more quicflected that asprosthesis to pi5 … if I put myck up an M&Mthat although s “all” things asks such as uperate zippers,r gripping.

Kelsey, the utilung age, promunt that they wr, limb loss w

mate site upon wacing with ev

nts worked best

driving, prosthation of an prostheses, noexplained. R

“independentflour into cups while installinothers wrong ain how they

but can still d

portant role induals, we also upled for indivunderstand thisimb loss as “brd the word t didn’t identif

d, I mentally tI can pretty

know a better ta hand, but c

prostheses as ato do everytnoting they “red his perceporkarounds tos how he tiesToday Brian

nd,” a descripresenting an

ion, so much s

red prostheses ounced, missinthat she quickckly without a s a toddler, hick up M&M’s

y face down or M one by one.”

she does nin her envir

using the hooke, and secures u

lity of prosthempting them towere able to d

was deeply engrwhich they exp

veryday objectt for them.

heses often able and

one of that Recognizing tly” with a ps without ng curtains about their

presented

do

n enabling found that

viduals who s coupling, being a big “disabled”

fy with it:

think that I y much do term for it. can still do

a child, but thing.” He “got in the ption of his o complete s his shoes n considers iption that n able self so, that the

as a child. ng parts of kly learned prosthesis.

her parents s to eat: “It I could put

” However, not use a ronment to ed tines on

utensils into

ses did not o denounce do anything rained into perimented ts to learn

Although Brian and Kelsey had congenital limb loss, only ever knowing themselves and their bodies with a limb difference, we also found that those who had amputations later in life reported that prostheses could be a hindrance to presenting an able self. For example, Michael, whose arm was amputated after a motorcycle accident as an adult, found a hook prosthesis useless after attempting myriad tasks such as tying shoes or cooking: “[the prosthesis] is frustrating and not useful…after my accident, after trying it, I decided not to use it.” He further explained that he often dropped books as soon as he picked them up, finding that using a prosthesis “takes more energy than not using one.” Similar to Brian and Kelsey, Michael found creative ways to use objects from the environment: “in the kitchen, for instance, we have a pair of scissors … I use that for soda bottles and things like that.” Similar to our prosthesis users, these individuals found clever modifications, including everyday objects, expanding their intimate laboratories and making their environments work for them.

The stories above show how people incorporated limb loss into their ability identity and how prosthesis could extend this identification to sites and systems beyond the body. Prostheses provided a helpful means of achieving tasks for some, but they also became platforms for experimenting with the body. All of our interviewees tried prostheses, as they navigated the interplay of ability and identify production in their daily lives. Christina communicated her enjoyment of fashion through her sparkly prosthetic extensions and Ben countered potential ablest assumptions by declaring he could “do anything” with one hand. Whether or not this prosthesis use continued, people tested and developed their ability identity through corporeal interventions.

Navigating Normalcy and Popular Culture As those we spoke with presented reflections of their perceptions of ability and self, tensions around ideas of normalcy emerged. Facing pressure to conform to the expectation that everyone should have a body with two hands, participants found ways to conceal limb loss. However, these efforts were often complex. They had to weigh other factors such as insurance coverage as they figured new ways to conform. Additionally, participants violated their perceptions of what society considers “normal” when they used their prostheses to gain positive attention and look “cool.” To understand this process we turn to the story of Elizabeth.

Elizabeth grew up using prostheses. She described how consistent encouragement from her parents to wear her prosthesis had an impact on how she preferred to present herself as an adult. “I am actually not comfortable not wearing it in front of the people who I don’t know well. So my family and fiancé, that’s fine. Beyond that, I am a little uncomfortable. I think that’s because my parents emphasized it at a young age that I am supposed to wear it all the time. So I got used to that. And at this point, it has become my habit like if I don’t put on my clothes when I go

out. Even though sometimes functionally it might be better not to have it. That’s kinda like my thing that I am working on to get over.” Though Elizabeth suggested there may be benefits to becoming more comfortable removing her prosthesis in public, her habit of wearing it trumped practicality.

However, she also wore a prosthesis to present a two-handed body which she believed would defer unwanted attention. For example Elizabeth would deliberately ignore stares as she considered limb loss irrelevant to who she is. She prided herself in how long it took some friends to learn that she used a prosthesis. She humorously mimicked the surprise when describing her record time concealing her limb loss from friends: “I have friends who I know for 4-6 months. Sometimes people won’t notice until I start to wear short sleeves. And then they are like “wow”. That’s funny…I don’t really see a reason to bring it up because it doesn’t affect how I interact with people generally.”

Elizabeth even continued to wear her prosthesis while it was broken and she was waiting for a replacement. “For a period of about 6 months, my hand started to open very slowly. It got worse and worse, until finally it stopped working. I had to be careful to get it in the right and least inconvenient position (slightly open) for typing.” Her continued use of the prosthesis despite malfunction illustrates how important it was for her to present a two-handed self, and to even problem solve methods to continue using a malfunctioning prosthesis.

Though Elizabeth always wore her myoelectric hand in public, she was not always satisfied with its appearance. She used a rubber protective covering that not only prevented water from ruining the circuitry, but matched her skin tone. Elizabeth lamented that the coverings were expensive, and only covered by insurance every two years. However, they deteriorated much more quickly. Elizabeth had learned to draw humor out of her all-to-often discolored covering. She described that her current covering, which she had worn for a year and a half began to discolor after just six months. She laughed saying it is “ugly, but it’s doing pretty well.” It was clearly very important for Elizabeth to present herself with two hands, yet she had learned to cope with a discolored covering since cost prohibited her from purchasing them as often as she would like.

Elizabeth’s story illustrates the complexities of a seemingly simple desire to direct attention away from her prosthesis. Her navigation of perceived societal expectations of a two-handed body demonstrates the tensions underlying the negotiation of appearing normal. Since Elizabeth had a life-long habit of wearing her prosthesis, she was comfortable wearing it. Further, she loathed unwanted attention toward her prosthesis and found that wearing it concealed her limb loss to the point that even friends did not realize it for a time. However, as outside circumstances such as her parents influenced her preference to wear her prosthesis

even when inefficient, outside circumstances led her to accept some annoying aspects of prostheses. Using humor to make fun of the poor quality coverings that discolor, she accepted that she must comply with her insurance company’s purchasing schedule or pay financially and socially by having hands that appear differently. Though outside circumstances clearly played a role in negotiating normalcy, Elizabeth used her body as an intimate laboratory, experimenting with ways to conceal limb loss. By complying with perceived normative expectations, she uses the look of her body, such as her skin color and her biological hand, as foundations for how prostheses should work as forms of self-expression.

We found similar stories from our other interviewees about unique strategies for navigating normal. Sometimes, participants complied with assumptions that a body should have two hands. One woman described wearing her passive arm during adolescence to appear more normal, though the arm was actually purchased to assist with balance while swimming. The desire to present a two-handed norm extended out of the pool and into daily life. At other times, they drew positive attention to their limb loss and used humor as a platform for deviating from a two-handed norm. Christina, with her sparkling arm, deliberately violated perceived societal expectations to create her own normal. Others centralized their prostheses or limb loss into costumes, such as portraying a pirate or a surfer with a shark-bitten board: “I dressed up as Bethanie Hamilton, the surfer girl, in high school for celebrity day. … or a pirate for Halloween.” Multiple people elevated prostheses to spectacles at show-and-tell, yet chose not to use them in their daily lives. Each person found their own way to navigate normal, incorporating different influences and concerns, within and beyond their control into how they presented themselves to others.

The Role of the e-NABLE Community Next we consider how the e-NABLE community has leveraged an association between prostheses and Do-It-Yourself tinkering to steer attention toward limb loss and prostheses. e-NABLE has been successful in bringing prostheses to the forefront of the popular imagination by cultivating a community. In one example, the star of the movie Iron Man even volunteered to help design and deliver a custom hand for a 7-year-old boy [39]. However, the tools it provides are neither technically groundbreaking nor pragmatic. Ivan Owen described how the designs are “nothing novel” but based upon eighteenth century designs that were originally carved of wood. Rather, the novelty comes through the technology that enabled designers from around the world to connect and create together. Of our five participants who successfully received and tried e-NABLE hands, none used them for functional benefits. Instead, the e-NABLE hands offered people with limb loss (and some engineering or mechanical expertise) an opportunity to exercise more agency over their devices through co-creation. Participants perceived the connections the e-

NABLE community provided them as beneficial in other ways, as the next two stories of e-NABLE users illuminate.

Donald spoke with us just one year after cutting his fingers of one hand off with a table saw. Though he recounted the experience while laughing, he detailed adjustments he has made such as asking his wife to open bottles and straining to fit his hand around his truck’s door handle. He first investigated purchasing a passive prosthesis which would provide no function. He ranted about the quoted $12,500 price tag, calculating during our interview how many months of social security he would have to allocate for the purchase. His pharmacist introduced him to the e-NABLE community, and he was paired with a volunteer who worked with him to redesign an open-source hand to fit his specifications. For example, since Donald had the palm of his hand, and original designs included a hand piece, the volunteer changed the design so a plate with a tension string could be stretched over his hand. However, similar to Kelsey and Brian’s stories above, Donald found the prosthesis more of a hindrance than a help and resolved that when wearing it he “can’t do anything.” He described asking his wife for assistance assembling the hand, since it is “impossible to do one handed,” and he has even tried to adapt the device to work better. He glued an arthritis glove over the hand in hopes of gripping objects more easily, but he has yet to find a glue that adheres to the hand for more than one day. Despite these functional failures, the hand gave Donald an opportunity to connect with others grappling with these design challenges. He revered the e-NABLE community for their intent, reiterating that, “It’s all volunteer. There’s no cost to me, not even shipping.”

The above story begins to show how e-NABLE impacted our participants, but not in the way one might expect. For those with shop experience such as Donald, e-NABLE provided an opportunity to improve the design of prosthetic hands by collaborating with like-minded makers. Though the e-NABLE device failed functionally, the volunteer effort the operation afforded offered an appealing alternative to more expensive devices: “This whole e-NABLE organization that’s reaching out to thousands of people all over the world to be able to help. I think that’s just tremendous.”

Next we consider how another person we spoke with chose not to use their e-NABLE hand, but similarly found the mission venerable, and the community supportive.

James was born with no fingers on his right hand. When James traveled to his first e-NABLE convention he was walking with his left hand in his pocket and demonstrating what he called “reclusive” social conduct. At the event he met a one-handed chef. The chef’s achievements challenged James’s ideas of his own ability. James explained: “He’s able to do his work as well as anybody else.”

Since the convention, James has come out of his shell to detail stories of his contribution to assistive technology.

James volunteers as an accessibility instructor, using his limb loss to support prosthetics education and is comfortable sharing his limb loss with others. Like Donald, he described that the device did not improve his function – “I really can’t use the hand” – and that the hands had failed multiple times; however, he excitedly detailed each design he had received. He was clearly engaged with the process, stating that “I’m so fascinated by this [the e-NABLE community] … I really have lived my life with this thing and I see a lot of hope for the future for people who are born with limb deficiencies.” Donald. even posited that: “I’ve been thinking of getting a 3D-printer myself.”

Like Donald, James did not gain function by using an e-NABLE hand. However, they both learned something from the community made available to them by e-NABLE. Through meeting others with limb loss and working collaboratively on designs, they began to project new meanings onto ability. For Donald, the community offered opportunities to connect with others to improve upon the design of his hand. For James, meeting others with limb loss helped him to become more comfortable with his own body and to share limb loss with others to promote further low-cost and innovative prosthesis design.

Participants also expressed how the e-NABLE community has brought images of limb loss to popular media, providing a platform for transforming their own and others’ perceptions of normalcy. As one e-NABLE recipient shared: “One of the fantastic things is [e-NABLE] raises awareness and it makes AT [assistive technology] cool and brings it to popular culture …in the public attention …all of this positive attention instead of negative attention.” Some explained that the e-NABLE community offers a platform for flexibility, by designing and creating hands that can be personalized and created to emulate spectacles in popular culture. For example, Steve, who was born with no fingers on his left hand, co-created an e-NABLE hand out of curiosity, explaining: “[its] rather big and super hero looking,” but “as of now, I have not found a use for it.” Steve regularly shows his e-NABLE “super hero Avenger’s” hand to children, rarely using it otherwise.

Making prostheses “cool,” in Steve’s words, and playing on what uses of prostheses elicit attention, connected with people’s interest in other forms of creative repurposing. Decorating, augmenting, and customizing prosthesis and other assistive technology were important aspects of prostheses engagement for our interviewees. Adornment could take the form of temporary adjustments, such as incorporating prostheses into Halloween costumes. After dressing up as a pirate, one woman continued to share how her friends without limb loss wanted their own prosthesis. In response, they stretched out wire hangers, pushed the elongated wire up their sleeves and curled their fingers to reveal the hook-like top of the hanger. In other moments, prosthetic interventions became more permanent, such as Christina’s sparkly arm.

Here, we saw participants acting in anticipation of and in response to an imaginative engagement with their prostheses, often garnering positive attention socially. Indeed, participants imagined new uses for prostheses before and without e-NABLE. In this sense, rather than transform the field of engagement, e-NABLE begins to extend the range of possibilities for people with limb loss to present themselves with a variety of prosthetic forms.

DISCUSSION Our study has begun to draw out the vastly different roles prostheses can play in the production of ability identity and the navigation of normalcy. We observed participants’ desire to present capable selves, whether they use traditional prostheses, 3D-printed prostheses or none at all. Some deferred attention — Elizabeth’s efforts to ignore “stares” unless confronted directly — while others took advantage of opportunities to gain positive attention from their peers about their prostheses, from incorporating limb loss into costumes to Steve’s “Avenger’s” e-NABLE hand.

In parallel, the e-NABLE community illustrated paradoxical benefits when compared to the design of assistive technologies that often prioritize function. While the e-NABLE community may inspire people with limb loss to co-create and come together for a common cause, the hands thus far present serious challenges to engagement. Recall Donald’s attempts to make his hand more useful and James’s lack of confidence, which shifted with the emergence of new connections with others, working and making through limb loss. e-NABLE thus extended the range of possibilities already at play in our interviewees’ social worlds.

But what does this work have to do with assistive technology or maker developments in HCI? And how might HCI learn from these findings? As the HCI community continues to expand its interest in the largely separate spheres of accessibility and making [7,13], our findings illustrate how these communities may blend in ways that shift the stakes of assistive technology, and redefine the relationship between ability and the body. For our interviewees, we see both mundane modifications and e-NABLE narratives surface new tensions around the ability-marked-body. They begin to trouble an often-assumed binary of ability and disability that inform broader cultural expectations. The fact that technology can be used to extend capacities to engage in private and public life, suggests HCI scholars might forge new partnerships with existing community stakeholders to accommodate these possibilities, identifying new social mechanisms that use assistive technology design to promote and celebrate myriad abilities from the ground up.

Treating such tools as social mechanisms suggests viewing assistive technology as an important site of material and symbolic experimentation. This extends Sobchack’s idea of the “intimate laboratory” to emphasize the range of interventions that refigure the body. Prostheses not only

help people with instrumental actions (pick up food or drive), but also produce shifting identifications and conceptions of normalcy. Dressing up as pirates or a surfer with one arm, participants positioned their bodies as material sites of creativity and experimentation, impersonating others with limb loss to construct different types of bodies and associated ability identities. By considering assistive technology — and e-NABLE in particular — as an integral dimension of this experimentation, we begin to surface alternative concepts of what a body is, and to recognize that assistive technologies, as other objects, can play crucial roles in identity production. It is by recognizing the consequences of experimentation that we may weigh and prevent pitfalls as this work continues.

As it stands, the development of assistive technology and prostheses is laden with unspoken goals of replacing or augmenting human ability in an effort to move people with limb loss toward particular forms of normative action. Understanding assistive technology as affording such inclusion proffers an incomplete narrative wherein technology development remains the primary site of experimentation. Instead, we consider what fixtures design may influence to allow the body to interface with objects, to constitute new assistive configurations, and to negotiate sites of self-expression. As alluded to above, the importance of imagination in this experimentation remained central – as it prompted participants to leverage objects in their everyday environments to create clever and practical assistance unintended at inception (e.g., Kelsey’s utensils secured in foam tubing for easier gripping). Broadening the definition of assistive technology not only invites us to reimagine how we refer to devices but it opens the door for the HCI community to consider the importance of extending the indeterminacy of prosthetic encounters beyond function. Such extensions should incorporate the narrative of the unique but underrepresented discovery that comes with the experience of limb loss that shaped our interlocutors’ lives.

As HCI continues to examine the intersections of maker culture and assistive technology, we confront new questions and challenges. Assistive technology, as explored through experimentation with the body, now invites a consideration of what exactly the “assistive” is all about. Does assistive technology allow people with limb loss to reimagine how their body can define normative action, or does it extend lines of imagination already in place? Does it help us develop our notions of how one body can “exceed” another or rather how a body can be done differently? A bottom up approach of providing materials to make the body whole again connotes a stopping point. However, experimentation defines no whole, no stopping point at which any body is “normal.” It is here that we challenge communities of makers such as e-NABLE to begin to subtly build on people’s ongoing processes of experimentation. Rather than

start a revolution, new efforts of small-scale manufacturing may enliven existing facets of sociotechnical life.

CONCLUSION The stories above have described experiences of people with limb loss who confronted prescribed and 3D-printed prostheses. We learned that presenting able selves was incredibly important to our interlocutors, as they used a variety of tools and language to perpetuate a particular ability identity. We also observed deeply-held perceptions of what is normal. Sometimes compliant and other times defiant, people incorporated multiple ideas of self-presentation into their own definitions of normalcy. Though new, the e-NABLE community has already begun to elicit similar features of identity production. The benefits that we observed – connecting makers and people with limb loss, allowing people with limb loss to become more comfortable with their sense of self, escalating prostheses into popular culture – reflect roles of assistive technology often overlooked based on definitions that prioritize function. Our work helped surface crucial questions about the role of design interventions in identity production, new directions for the maker community as it intersects with assistive technology, and, ultimately, challenges to current definitions of “assistive” technology which prioritize function and often neglect the intimate laboratories they inhabit.

ACKNOWLEDGEMENTS We would like to thank our interlocutors for their generous participation in this work. Research for this paper was supported by funding provided under NSF #1453329.

REFERENCES 1. American Board for Certification in Orthotics,

Prosthetics & Pedorthics. History. Retrieved 9/2015 from https://www.abcop.org/WhoWeAre/Pages/History.aspx

2. American Orthotic Prosthetic Association. 2015. AOPA Statement on 3-D Printing in Prosthetics.

3. Morgan G. Ames, Jeffrey Bardzell, Shaowen Bardzell, Silvia Lindtner, David A. Mellis, and Daniela K. Rosner. 2014. Making cultures: empowerment, participation, and democracy - or not?. In CHI '14 Extended Abstracts on Human Factors in Computing Systems (CHI EA '14), 1087-1092. http://dx.doi.org/10.1145/2559206.2579405.

4. Chris Anderson. 2013. Makers. Wereldbibliotheek.

5. Elaine Biddiss, & Tom Chau. 2007. Upper-limb prosthetics: critical factors in device abandonment. American Journal of Physical Medicine & Rehabilitation, 86, 12: 977-987.

6. John N. Billock. 1986. Upper limb prosthetic terminal devices: Hands versus hooks., Clin Prosthet Orthot, 10, 2: 57-65.

7. Erin Buehler, Stacy Branham, Abdullah Ali, Jeremy J. Chang, Megan Kelly Hofmann, Amy Hurst, and Shaun

K. Kane. 2015. Sharing is Caring: Assistive Technology Designs on Thingiverse. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (CHI '15), 525-534. http://doi.acm.org/10.1145/2702123.2702525

8. Judith Butler. 2002. Gender trouble. Routledge, 195.

9. Kathy Charmaz. 2006. Constructing grounded theory: A practical guide through qualitative research. SagePublications Ltd, London.

10. Laura Devendorf and Kimiko Ryokai. 2015. Being the Machine: Reconfiguring Agency and Control in Hybrid Fabrication. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (CHI '15), 2477-2486. http://dx.doi.org/10.1145/2702123.2702547

11. e-NABLE. 2015. Enabling the Future. Retrieved 7/12/15 from http://enablingthefuture.org/

12. Barney Glaser, and Anselm Strauss. 1967. The discovery of grounded theory: strategies for qualitative inquiry. Aldine.

13. Amy Hurst, and Jasmine Tobias. 2011. Empowering individuals with do-it-yourself assistive technology. In The proceedings of the 13th international ACM SIGACCESS conference on Computers and accessibility (ASSETS '11), 11-18. http://doi.acm.org/10.1145/2049536.2049541

14. J. C. K. Lai, M. P. Schoen, A. Perez Gracia, D. S. Naidu., & S. W. Leung. 2007. Prosthetic devices: challenges and implications of robotic implants and biological interfaces. In Proc. the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 221, 2, 173-183.

15. Silvia Lindtner, Garnet D. Hertz, and Paul Dourish. 2014. Emerging sites of HCI innovation: hackerspaces, hardware startups & incubators. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI '14), 439-448. http://dx.doi.org/10.1145/2556288.2557132

16. Craig W. Martin, and Demet Edeer. 2011. Upper Limb Prostheses: A Review of the Literature with a Focus on Myoelectric Hands. WorkSafeBC Evidence Based Practice Group.

17. Argyro Moraiti, Vero Vanden Abeele, Erwin Vanroye, and Luc Geurts. 2015. Empowering Occupational Therapists with a DIY-toolkit for Smart Soft Objects. In Proceedings of the Ninth International Conference on Tangible, Embedded, and Embodied Interaction (TEI '15), 387-394. http://doi.acm.org/10.1145/2677199.2680598

18. Sean V. Murphy and Anthony Atal. 2014. 3D bioprinting of tissues and organs. Nature biotechnology, 32, 8: 773-785.

19. Craig D. Murray,., & Mark J. Forshaw. 2013. The experience of amputation and prosthesis use for adults: a metasynthesis. Disability and rehabilitation, 35, 14: 1133-1142.

20. Myoelectric Prosthetics. 2015. Introduction to Upper Limb Prosthetics. Retrieved 7/22/15 from http://www.myoelectricprosthetics.com/

21. National Commission on orthotic and Prosthetic Education. Retrieved 9/2015 from http://www.ncope.org/

22. Hiedi Nielson. 2015. MANUFACTURING CONSUMER PROTECTION FOR 3-D PRINTED PRODUCTS. Ariz. L. Rev., 57, 610-635.

23. Kim Norton. 2007. A brief history of prosthetics. inMotion Magazine, 17.

24. Open Bionics. Retrieved 12/18/2015 from http://www.openbionics.com

25. Adele Peters. 2015. This Low-Cost 3-D Printer Can Produce Human Organs And Bones. Co.Exist.

26. Daniela Petrelli, Elise Van den Hoven, and Steve Whittaker. 2009. Making history: intentional capture of future memories. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI '09), 1723-1732. http://dx.doi.org/10.1145/1518701.1518966

27. Daniela Petrelli, Simon Bowen, and Steve Whittaker. 2014. Photo mementos: Designing digital media to represent ourselves at home. International Journal of Human-Computer Studies 72, 3: 320-336.

28. Ponoko. Retrieved 10/20/15 from https://www.ponoko.com/

29. Matt Ratto. Grease pencils and the persistence of individuality in computationally-produced custom objects.

30. Isaac Record, Matt Ratto, Amy Ratelle, Adriana Ieraci, and Nina Czegledy. 2013. DIY prosthetics workshops:‘Critical Making’for public understanding of human augmentation. In Technology and Society (ISTAS), 2013 IEEE International Symposium on, 117-125.

31. Linda Resnik , Marissa R. Meucci, Shana Lieberman-Klinger, Christopher Fantini, Debra L. Kelty, Roxanne Disla, Nicole Sasson. 2012. Advanced upper limb prosthetic devices: Implications for upper limb prosthetic rehabilitation. Arch Phys Med Rehabil. 93, 4: 710–17. http://dx.doi.org/10.1016/j.apmr.2011.11.010

32. David Roedl, Shaowen Bardzell, and Jeffrey Bardzell. 2015. Sustainable Making? Balancing Optimism and Criticism in HCI Discourse. ACM TOCHI 22, 3.

33. Ryan Schmidt, ginger coons, Vincent Chen, Timotheius Gmeiner, and Matt Ratto. 2015. 3D-printed

prosthetics for the developing world. In SIGGRAPH 2015: Studio (SIGGRAPH '15), Article 21, 1 pages. http://dx.doi.org/10.1145/2785585

34. D. Hal Silcox, Michael D. Rooks, Robert R. Vogel, and Lamar L. Fleming. 1993. Myoelectric prostheses. A long-term follow-up and a study of the use of alternate prostheses. The Journal of Bone & Joint Surgery, 75, 12: 1781-1789.

35. Skillshare. Retrieved 10/20/15 from https://www.skillshare.com/

36. Vivian Sobchack. 2010. Living a ‘phantom limb’: On the phenomenology of bodily integrity. Body & Society, 16, 3: 51-67.

37. Anselm Leonard Strauss, and Juliet M. Corbin. 1990. Basics of qualitative research. Vol. 15. Sage.

38. Lucy Suchman. 2009. Agencies in Technology Design: Feminist Reconfigurations Retrieved 03/16/2011 from http://www.lancs.ac.uk/fass/sociology/papers/suchman-agencies-technodesign.pdf

39. The Open Hand Project. Retrieved 12/18/2015 from http://www.openhandproject.org

40. The Collective Project. 2015. Robert Downey Jr. Delivers a Real Bionic Arm. Retrieved 9/24/15 from https://www.youtube.com/watch?v=oEx5lmbCKtY

41. Thingiverse. Things Tagged with e-NABLE. 2015. Retrieved 7/22/15 from https://www.thingiverse.com/tag:e-nable

42. Alan J. Thurston. 2007. Paré and prosthetics: the early history of artificial limbs. ANZ Journal of Surgery, 77, 12: 1114-1119.

43. Austin L. Toombs, Shaowen Bardzell, and Jeffrey Bardzell. 2015. The Proper Care and Feeding of Hackerspaces: Care Ethics and Cultures of Making. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (CHI '15), 629-638. http://dx.doi.org/10.1145/2702123.2702522

44. Nancy A. Van House. 2011. Feminist HCI meets facebook: Performativity and social networking sites. Interact. Comput. 23, 5 (September 2011), 422-429. http://dx.doi.org/10.1016/j.intcom.2011.03.003

45. Kathleen M. Woodward. 2006. Performing age, performing gender. NWSA journal18, 1: 162-189.

46. Jorge Zuniga, Dimitrios Katsavelis, Jean Peck, John Stollberg, Mark Petrykowski, Adam Carson, & Cristina Fernandez. 2015. Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences. BMC research notes, 8, 1: 10.